Alcohol-based hand sanitizer’s effect on hand barrier function induced Staphylococcus lugdunensis aortic and mitral valve endocarditis: a case report
Bibliographic record
Abstract
Background: The World Health Organization (WHO) and national disease control agencies emphasized the importance of hand hygiene to reduce the spread of the virus during COVID-19 pandemic to curb the spread of the virus coupled with vaccination. Alcohol-based hand sanitizer (ABHS) formulation is effective to reduce or eliminate bacterial or viral load, and commonly applied in the form of hand rub rinses, gel and foam, but it may impair skin barrier integrity and function, increasing the risk of hand dermatitis resulting local and/or systemic infections. Case Description: A 75-year-old woman used ABHS excessively without skin moisturizer resulted in bilateral dry skin-crack hands. Two weeks prior to hospital admission, she experienced progressive generalized fatigue, shortness of breath with moderate exertion, bilateral lower leg edema, orthopnea and paroxysmal nocturnal dyspnea associated with fever and chills. She was diagnosed with Staphylococcus lugdunensis (S. lugdunensis) aortic and mitral valve endocarditis. Intravenous (IV) antibiotics coupled with urgent cardiac surgery to replace the aortic valve, debridement and reconstruction of the left ventricular outflow track followed by a complex mitral valve repair. Her post-operative course complicated by requiring intra-aortic balloon pump (IABP), veno-venous extracorporeal membrane oxygenation (VV-ECMO) and continuous venous-venous hemodialysis (CVVHD). Despite decannulation of all three mechanical supports, the patient continued to have multiple intensive care unit (ICU) related medical and surgical complications, resulted in her mortality. Conclusions: Excessive use of ABHS without moisturizer can induce dry hands and skin damage, resulting in irritant or allergic contact dermatitis. The injured skin is a potential host for local and systemic infections such as the described case of S. lugdunensis endocarditis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".